BALANCED THERAPY AND WELLNESS – Physical Medicine & Rehabilitation Physician, NPI 1093183519
Physical Medicine & Rehabilitation Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for BALANCED THERAPY AND WELLNESS
5939 Roosevelt Blvd
Jacksonville, FL 322442356
Phone: (904) 412-2882
Type: Location
11 CRAZY HORSE CT
PALM COAST, FL 321379009
Phone: (904) 625-7674
Type: Mailing
5939 ROOSEVELT BLVD
JACKSONVILLE, FL 32244
Phone: (904) 625-7674
Type: Location
3948 3RD ST S # 133
JACKSONVILLE BEACH, FL 322505847
Phone: (904) 412-2882
Type: Mailing
7230 UNIVERSITY PKWY
LAKEWOOD RANCH, FL 342408330
Phone: (904) 412-2882
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-05-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-04-30 (772 days ago).
Enrollment records
1
Earliest due date
2024-04-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20170516001032 | O | Physical/Occupational Therapy Group In Private Practice | FL | 2024-04-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32244)
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